Healthcare Provider Details

I. General information

NPI: 1932031283
Provider Name (Legal Business Name): PRISCILLAS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21494 AVON LN
SOUTHFIELD MI
48075-7104
US

IV. Provider business mailing address

21494 AVON LN
SOUTHFIELD MI
48075-7104
US

V. Phone/Fax

Practice location:
  • Phone: 313-209-1041
  • Fax:
Mailing address:
  • Phone: 313-209-1041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY FOSTER
Title or Position: MANAGING OWNER
Credential:
Phone: 313-209-1041